Finasteride improves long-term urinary tract symptoms associated with benign prostatic hyperplasia (BPH) when compared with placebo, but it is less effective than the alpha blocker doxazosin, according to recent report in the Cochrane Database of Systemic Reviews.

A team led by Jack Tacklind, of the Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, analyzed data from more than 21,000 men in 23 clinical trials. In trials of longer than one year’s duration, finasteride consistently improved urinary symptom scores more than placebo and significantly lowered the risk of BPH progression. Doxazosin and another alpha blocker, terazosin, were significantly more likely than finasteride to improve peak urine flow and nocturia, the researchers stated. Long-term use of finasteride in combination with either doxazosin or terazosin improves symptoms significantly better than finasteride alone.